In patients with stable heart failure, sodium-glucose cotransporter 2 (SGLT2) inhibitors can alleviate the risk of heart failure or death due to cardiovascular causes. However, the effectiveness of SGLT2 inhibitors when used soon after a decompensated heart failure episode is not clear. This study aims to determine the efficacy and safety of sotagliflozin, an SGLT2 inhibitor, for diabetes after a recent worsening heart failure.

This double-blind, multicenter trial included a total of 1,222 patients with diabetes mellitus (type-2) who were recently hospitalized for worsening heart failure. The participants were randomly assigned in a 1:1 ratio to receive sotagliflozin or placebo. The primary outcome of the study was the total number of deaths due to cardiovascular causes, along with hospitalizations due to heart failure.

During a median follow-up of 9.0 months, 600 primary endpoints were reported, 245 in the sotagliflozin group and 355 in the placebo group. The findings suggested that the rate of primary endpoints was lower in the sotagliflozin group compared with the placebo group. The rate of cardiovascular death was 10.6 in the sotagliflozin group compared with 12.5 in the placebo group.

The research concluded that sotagliflozin therapy was safer and more efficacious than the placebo in patients with type-2 diabetes mellitus and a recent worsening heart failure.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2030183